Assessment Of Recent Prognostic Value Of Simplified Pulmonary Embolism Severity Index And Neutrophil To Lymphocyte Ratio In Patients With Acute Pulmonary Embolism

Objective To analyze the recent prognostic value of Simplified Pulmonary Embolism Severity Index and Neutrophil Lymphocyte Ratio in the evaluation of recent prognosis in patients with acute pulmonary embolism.Then provides clinical indicators and methods that can be used to rapidly predict the short-term prognosis of APE and have great significance for diagnosis and treatment.Methods The 131 APE patients who met the inclusion and exclusion criteria in our hospital from December 2011 to February 2018 were divided into no adverse event group(group A,n=91)and adverse event group(group B,n = 40 cases).The clinical indicators of the two groups of patients,Including basic data,admission simplified pulmonary embolism severity index score,NLR,etc,were analyzed to evaluate the short-term prognosis by retrospectively analyzed.Results 1.There was no statistically significant difference in basic clinical data between the two groups(P > 0.05).The difference in sPESI grade was statistically significant(P < 0.05).The peripheral blood leukocytes,neutrophils,NLR and platelet lymphocytes of group B were higher than group A,and the difference was statistically significant(P < 0.05).There were no statistically significant differences between lymphocytes,platelets,platelet volume,hemoglobin,RBC volume,arterial oxygen partial pressure and d-dimer(P> 0.05).2.In this study,WBC,NUET,NLR,PLR and sPESI scores of relevant indicators with statistical significance were analyzed for receiver operating characteristics(ROC).The area difference under ROC curve was statistically significant(P < 0.05).The Yodner index cutoffs of the continuous variable observation index incloud WBC,NUET,NLR,PLR and sPESI were 8.28,7.67,3.08,131.66 and 0.5 respectively.The ROC results showed that the optimal cutoff value of NLR is 3.08 and the optimal cutoff value of sPESI is 0.5.Taking these as the boundary value,NLR and sPESI are transformed into categorical variables respectively.The predictive value of sPESI combined with NLR was compared by sensitivity,specificity and AUC,and it was found that the data variables were statistical significance after being converted into classified variables(P< 0.05).However,the smaller AUC area reduces the original prediction value.3.Furthermore,univariate logistic regression analysis,was performed on the relevant indicators,found that SPESI score,WBC,NUET,NLR and PLR all had statistical significance(P<0.05).However the sPESI calculations include age,pulse,systolic blood pressure,PaO2,tumor,chronic heart failure and chronic lung disease were excluded in multifactor analysis to avoid collinearity.Logistic regression analysis of binary classification was carried out and found tha the difference of sPESI and NLR was statistically significant(P<0.05).It is an independent risk factor for adverse events in APE patients.It was found that WBC,NUET and PLR had no statistical significance after other factors were included(P > 0.05).Considering that it is not an independent risk factor for adverse events in hospital in APE patients.Conclusion High WBC,NUET,PLR,NLR,and sPESI scores can be used as risk factors to evaluate APE adverse events.High NLR and sPESI scores can be used as independent risk factors for APE poor prognosis and risk stratification assessment for APE patients.